中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2011年
2期
133-135
,共3页
裘刚%龚小慧%沈云琳%陈一欢%陈容欣
裘剛%龔小慧%瀋雲琳%陳一歡%陳容訢
구강%공소혜%침운림%진일환%진용흔
N端脑利钠肽前体%缺氧缺血性脑病%心肌损伤%婴儿,新生
N耑腦利鈉肽前體%缺氧缺血性腦病%心肌損傷%嬰兒,新生
N단뇌리납태전체%결양결혈성뇌병%심기손상%영인,신생
N-terminal pro-brain natriuretic peptide%Hypoxic-ischemic encephalopathy%Myocardial injury%Infant,newborn
目的 探讨N端脑利钠肽前体(NT-proBNP)在缺氧缺血性脑病(HIE)合并心肌损伤患儿中的变化,为临床早期诊断、治疗及预后判断提供依据.方法 选择我院收住的40例HIE患儿为研究对象(心肌损伤16例,非心肌损伤24例),以20例正常新生儿为对照组,应用ELISA方法测定血浆NT-proBNP水平;超声心动图测定患儿的心脏收缩功能.结果 (1)心肌损伤患儿NT-proBNP水平[(350±56)pmol/L]显著高于非心肌损伤组[(135±37)pmol/L]和正常对照组[(117±23)pmol/L],差异有统计学意义(P＜0.05);(2)轻、中、重度HIE组NT-proBNP水平分别为(132±34)pmol/L、(247±43)pmol/L和(343±53)pmol/L,中、重度HIE组显著高于对照组;轻、中、重度HIE组间比较差异有统计学意义(P＜0.05);(3)心肌损伤组急性期血浆NT-proBNP水平[(350±56)pmol/L]明显高于恢复期[(250±78)pmoyl/L],差异有统计学意义(P＜0.05);(4)HIE患儿NT-proBNP水平和肺动脉收缩压、左室收缩功能密切相关.结论 HIE合并心肌损伤急性期血浆NT-proBNP水平升高,有助于早期诊断心肌损伤,判断HIE病情.
目的 探討N耑腦利鈉肽前體(NT-proBNP)在缺氧缺血性腦病(HIE)閤併心肌損傷患兒中的變化,為臨床早期診斷、治療及預後判斷提供依據.方法 選擇我院收住的40例HIE患兒為研究對象(心肌損傷16例,非心肌損傷24例),以20例正常新生兒為對照組,應用ELISA方法測定血漿NT-proBNP水平;超聲心動圖測定患兒的心髒收縮功能.結果 (1)心肌損傷患兒NT-proBNP水平[(350±56)pmol/L]顯著高于非心肌損傷組[(135±37)pmol/L]和正常對照組[(117±23)pmol/L],差異有統計學意義(P＜0.05);(2)輕、中、重度HIE組NT-proBNP水平分彆為(132±34)pmol/L、(247±43)pmol/L和(343±53)pmol/L,中、重度HIE組顯著高于對照組;輕、中、重度HIE組間比較差異有統計學意義(P＜0.05);(3)心肌損傷組急性期血漿NT-proBNP水平[(350±56)pmol/L]明顯高于恢複期[(250±78)pmoyl/L],差異有統計學意義(P＜0.05);(4)HIE患兒NT-proBNP水平和肺動脈收縮壓、左室收縮功能密切相關.結論 HIE閤併心肌損傷急性期血漿NT-proBNP水平升高,有助于早期診斷心肌損傷,判斷HIE病情.
목적 탐토N단뇌리납태전체(NT-proBNP)재결양결혈성뇌병(HIE)합병심기손상환인중적변화,위림상조기진단、치료급예후판단제공의거.방법 선택아원수주적40례HIE환인위연구대상(심기손상16례,비심기손상24례),이20례정상신생인위대조조,응용ELISA방법측정혈장NT-proBNP수평;초성심동도측정환인적심장수축공능.결과 (1)심기손상환인NT-proBNP수평[(350±56)pmol/L]현저고우비심기손상조[(135±37)pmol/L]화정상대조조[(117±23)pmol/L],차이유통계학의의(P＜0.05);(2)경、중、중도HIE조NT-proBNP수평분별위(132±34)pmol/L、(247±43)pmol/L화(343±53)pmol/L,중、중도HIE조현저고우대조조;경、중、중도HIE조간비교차이유통계학의의(P＜0.05);(3)심기손상조급성기혈장NT-proBNP수평[(350±56)pmol/L]명현고우회복기[(250±78)pmoyl/L],차이유통계학의의(P＜0.05);(4)HIE환인NT-proBNP수평화폐동맥수축압、좌실수축공능밀절상관.결론 HIE합병심기손상급성기혈장NT-proBNP수평승고,유조우조기진단심기손상,판단HIE병정.
Objective To investigate the changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) in neonates with hypoxic-ischemic encephalopathy (HIE) complicated by myocardial ischemic injury. Methods Forty neonates with HIE ( 16 cases with concurrent myocardial injury and 24 cases without) were enrolled. Twenty healthy neonates were used as control. Plasma NT-proBNP levels were measured using enzyme immunoassay. Cardiac function was measured by echocardiography. Results ( 1 ) The mean plasma NT-proBNP levels in patients with myocardial injury[(350 ± 56) pmol/L]were significantly higher than those in patients without myocardial injury[(135 ± 37 ) pmol/L]and in the control group [(117 ±23) pmol/L](P ＜0. 05). (2) The NT-proBNP levels in mild,moderate and severe HIE neonates were ( 132 ±34) pmol/L, (247 ±43) pmol/L and (343 ±53) pmol/L. Compared with the control group,the NT-proBNP levels in the neonates with moderate and severe HIE significantly increased. There were significant differences in the NT-proBNP levels among the mild, moderate and severe HIE neonates ( P ＜ 0. 05 ).(3) In patients with myocardial injury,the NT-proBNP levels significantly decreased in the convalescent phase [(250±78) pmol/L]compared with those in the acute phase[(350±56) pmol/L](P ＜0.05). (4) The NT-proBNP levels were significantly related with left ventricular ejection fraction. Conclusion Plasma NT-proBNP levels increase in neonates with HIE complicated with myocardial ischemic injury in the acute phase.Detection of NT-proBNP levels maybe useful in the diagnosis of myocardial ischemic injury and severe HIE.
